Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Locations of metastases in and oncological outcomes of patients with metastatic castration-sensitive prostate cancer: Real-world data from a multicenter study","authors":"Fumihiko Urabe M.D., Ph.D. ,&nbsp;Kojiro Tashiro M.D. ,&nbsp;Katsuki Muramoto M.D. ,&nbsp;Takafumi Yanagisawa M.D., Ph.D. ,&nbsp;Kota Katsumi M.D. ,&nbsp;Hidetsugu Takahashi M.D. ,&nbsp;Shuhei Hara M.D. ,&nbsp;Wataru Fukuokaya M.D. ,&nbsp;Yu Imai M.D., Ph.D. ,&nbsp;Kosuke Iwatani M.D. ,&nbsp;Mahito Atsuta M.D. ,&nbsp;Keiichiro Mori M.D., Ph.D. ,&nbsp;Taro Igarashi M.D., Ph.D. ,&nbsp;Shoji Kimura M.D., Ph.D. ,&nbsp;Masaya Murakami M.D., Ph.D. ,&nbsp;Shunsuke Tsuzuki M.D., Ph.D. ,&nbsp;Takaya Sasaki M.D., Ph.D. ,&nbsp;Tatsuya Shimomura M.D., Ph.D. ,&nbsp;Jun Miki M.D., Ph.D. ,&nbsp;Takahiro Kimura M.D., Ph.D.","doi":"10.1016/j.urolonc.2025.02.007","DOIUrl":"10.1016/j.urolonc.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Androgen receptor-signaling inhibitors (ARSIs) have significantly changed the preferred treatments for metastatic castration-sensitive prostate cancer (mCSPC). Despite such advances, the prognostic significance of metastases at specific sites remains unclear. This study evaluated how metastatic site affected the oncological outcomes of mCSPC patients.</div></div><div><h3>Methods</h3><div>This retrospective multicenter study included 716 mCSPC patients receiving androgen- deprivation therapy (ADT) alone, combined androgen blockade (CAB) therapy, or both ARSI and ADT (ARSI doublet) from February 2018 to June 2023. All patients were categorized based on their metastatic sites. The primary endpoint was the time to castration-resistant prostate cancer (CRPC) development; the secondary endpoints were progression-free survival 2 (PFS2), cancer-specific survival (CSS), and overall survival (OS). Kaplan-Meier curves and multivariate Cox's regression models were used to analyze the survival outcomes. We stratified mCSPC patients with bone metastases by the volumes of such metastases and lung metastasis status, and explored the clinical significance of lung metastasis.</div></div><div><h3>Results</h3><div>Patients with lung-only metastases experienced better outcomes than those with other visceral metastases. On multivariate analysis, the bone metastasis volume, but not lung metastasis status, significantly affected CRPC-free survival status. No significant difference in any of CRPC, PFS2, CSS, or OS status was apparent among patients with bone metastases with or without lung metastases. In terms of interaction, lung metastasis did not significantly affect the prognoses of patients with either low- or high-volume bone metastases.</div></div><div><h3>Conclusion</h3><div>In the present era of ARSI doublet therapy, lung-only metastases in mCSPC patients were associated with favorable outcomes. The negative prognostic effects of lung metastases were much lower than was the bone metastasis volume, indicating that treatments targeting low-volume disease may be adequate even when lung metastases are apparent.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 336.e1-336.e11"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does inclusion of neighborhood variables improve clinical risk prediction for advanced prostate cancer in Black and White men?","authors":"Erin K. Tagai Ph.D., M.P.H. ,&nbsp;Elizabeth A. Handorf Ph.D. ,&nbsp;Kristen A. Sorice B.A. ,&nbsp;Carolyn Y. Fang Ph.D. ,&nbsp;Mengying Deng M.S. ,&nbsp;Mary B. Daly M.D. ,&nbsp;Adam C. Reese M.D. ,&nbsp;Kevin A. Henry Ph.D. ,&nbsp;Camille Ragin Ph.D., M.P.H. ,&nbsp;Shannon M. Lynch Ph.D., M.P.H.","doi":"10.1016/j.urolonc.2025.02.021","DOIUrl":"10.1016/j.urolonc.2025.02.021","url":null,"abstract":"<div><h3>Introduction</h3><div>Black men are diagnosed with high-grade prostate cancer (PCa; Gleason sum ≥7) at greater rates than White men. This persistent disparity has led to mortality rates among Black men that are twice the rate of White men. Risk prediction tools can aid clinical decision making for PCa screening, biopsy, and treatment. However, research has not integrated neighborhood-level risk factors that are associated with rates of high-grade PCa. This study sought to determine whether inclusion of neighborhood-level variables can improve prediction of high-grade PCa over the existing Prostate Cancer Prevention Trial (PCPT) calculator.</div></div><div><h3>Methods</h3><div>Existing PCa cases from 2005 to 2017 were ascertained from urology, radiation, and medical oncology clinics at Fox Chase Cancer Center/Temple University Health System (FCCC/TUHS). Existing databases from patient medical records, biosamples, pathology, and neighborhood data from the U.S. census were linked via geocodes. Informed by prior studies that selected social environmental variables, a series of logistic regression models were completed to predict the probability of high-grade PCa on prespecified sets of variables from the PCPT.</div></div><div><h3>Results</h3><div>Our best fitting, multilevel model included PCPT variables (i.e., PSA, digital rectal exam, age, race, prior biopsy, family history) as well as insurance status, neighborhood-level poverty, residence in a high risk PCa cluster, and % of Employed Men in Protective Service Occupations. However, the AUC for this model (0.673) was only marginally improved from the initial model of only PCPT variables (0.671). Further, in separate analyses by race (White, Black) the % of Employed Men in Protective Service Occupations was only significant among White men.</div></div><div><h3>Discussion</h3><div>Study findings demonstrate the potential for neighborhood variables to enhance current risk prediction models and identify interaction effects revealing differences across subgroups, such as race. The lack of significant associations between neighborhood variables and Black men highlight the complexity of systemic racism and neighborhood-level variables on PCa outcomes.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 334.e17-334.e24"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncologic outcomes of pelvic organ-preserving radical cystectomy vs. Standard radical cystectomy: A systematic review and meta-analysis","authors":"David E. Hinojosa-Gonzalez ,&nbsp;Gal Saffati ,&nbsp;Eric Wahlstedt ,&nbsp;Madeline Chaput ,&nbsp;Sagar R. Patel ,&nbsp;Gustavo Salgado-Garza ,&nbsp;Shane Kronstedt ,&nbsp;Michal R. Segall ,&nbsp;Juan C. Angulo-Lozano ,&nbsp;Jeffrey A. Jones ,&nbsp;Jennifer M. Taylor ,&nbsp;Jeremy R. Slawin","doi":"10.1016/j.urolonc.2024.09.024","DOIUrl":"10.1016/j.urolonc.2024.09.024","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Radical Cystectomy is indicated in muscle-invasive bladder cancer and select cases of nonmuscle invasive bladder cancer. Women often undergo additional reproductive organ removal, greatly impacting sexual function and quality of life. Pelvic organ-preserving radical cystectomy aims to mitigate these effects, but its oncologic outcomes are not well-defined. This presents a meta-analysis of available literature on oncological outcomes of pelvic organ-preserving radical cystectomy in women with muscle invasive disease.</div></div><div><h3>Methods</h3><div>A systematic search across PubMed, Web of Science, Scopus, and Google Scholar was performed to identify studies comparing oncological outcomes between pelvic organ-preserving radical cystectomy and standard radical cystectomy in women with muscle-invasive bladder cancer or high-risk or recurrent nonmuscle invasive cancer. The search included English or Spanish studies, statistically comparing overall survival, cancer-specific survival, and recurrence-free survival. Statistical analysis used Review Manager, employing fixed or random-effects models based on heterogeneity.</div></div><div><h3>Key Findings and Limitations</h3><div>Six retrospective studies met inclusion criteria, totaling 597 patients of which 303 received pelvic organ-preserving radical cystectomy and 294 received standard radical cystectomy. Overall Survival was not different between the 2 groups (HR 1.05 [0.77, 1.43]; <em>P</em> = 0.77). Cancer-Specific Survival also was found to be not different between the 2 groups (HR 1.27 [0.86, 1.87]; <em>P</em> = 0.22). Additionally, recurrence-free survival was not different between the 2 groups (HR 0.85 [0.41, 1.75]; <em>P</em> = 0.65. Four of the included studies exhibited a moderate risk of bias, with 1 study demonstrating low risk and the remaining study manifesting a serious risk of bias.</div></div><div><h3>Conclusion</h3><div>The comparison showed no significant differences in overall survival, cancer-specific survival, or recurrence-free survival rates.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 275-285"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary tumor ablation in metastatic renal cell carcinoma","authors":"Lukas Scheipner M.D. ,&nbsp;Reha-Baris Incesu M.D. ,&nbsp;Simone Morra M.D. ,&nbsp;Andrea Baudo M.D. ,&nbsp;Letizia Maria Ippolita Jannello M.D. ,&nbsp;Carolin Siech M.D. ,&nbsp;Mario de Angelis M.D. ,&nbsp;Anis Assad M.D. ,&nbsp;Zhe Tian M.Sc. ,&nbsp;Fred Saad M.D. ,&nbsp;Shahrokh F. Shariat M.D. ,&nbsp;Alberto Briganti M.D. ,&nbsp;Felix K.H. Chun M.D. ,&nbsp;Derya Tilki M.D. ,&nbsp;Nicola Longo M.D. ,&nbsp;Luca Carmignani M.D. ,&nbsp;Ottavio De Cobelli M.D. ,&nbsp;Martin Pichler M.D. ,&nbsp;Sascha Ahyai M.D. ,&nbsp;Pierre I. Karakiewicz M.D.","doi":"10.1016/j.urolonc.2024.10.019","DOIUrl":"10.1016/j.urolonc.2024.10.019","url":null,"abstract":"<div><h3>Background</h3><div>The role of primary tumor ablation (pTA) in metastatic renal cell carcinoma (mRCC) is unknown. We compared pTA-treated mRCC patients to patients who underwent no local treatment (NLT), as well as patients who underwent cytoreductive nephrectomy (CN).</div></div><div><h3>Methods</h3><div>Within the Surveillance, Epidemiology, and End Results database (SEER, 2004–2020), we identified mRCC patients who underwent either pTA, NLT or CN. Endpoints consisted of overall survival (OM) and other-cause mortality (OCM). Propensity score 1:1 matching (PSM), multivariable cox regression models (OM), as well as, multivariable competing risk regressions (CRR) models (OCM) were used.</div></div><div><h3>Results</h3><div>We identified 27,087 mRCC patients, of whom 82 (0.3%) underwent pTA, 17,266 (64%) NLT and 9,739 (36%) CN. In comparisons of pTA vs. NLT mRCC patients addressing OM, after 1:1 PSM, median survival was 19 months for pTA vs. 4 months for NLT patients (multivariable HR 0.3, 95% CI 0.22–0.47, <em>P &lt;</em> 0.001). No statistically significant OCM differences were recorded in multivariable CRR (HR 1.13 95%, CI 0.52–2.44, <em>P =</em> 0.8). In comparisons of pTA vs. CN, after 1:1 PSM, no statistically significant differences in OM (HR 1.22, 95% CI 0.81–1.83, <em>P =</em> 0.32), as well as OCM (HR 1.4, 95% CI 0.56–3.48, <em>P =</em> 0.5) were recorded.</div></div><div><h3>Conclusion</h3><div>In mRCC patients, pTA is associated with significantly lower mortality compared to NLT. Interestingly, OM rates between pTA and CN mRCC patients do not exhibit statistically significant differences. This preliminary report may suggest that pTA may provide a comparable survival benefit to CN in highly selected mRCC patients.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 332.e11-332.e18"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A noninvasive comprehensive model based on medium sample size had good diagnostic performance in distinguishing renal fat-poor angiomyolipoma from homogeneous clear cell renal cell carcinoma","authors":"Jinyan Wei ,&nbsp;Yurong Ma ,&nbsp;Jianqiang Liu ,&nbsp;Jianhong Zhao ,&nbsp;Junlin Zhou","doi":"10.1016/j.urolonc.2024.11.013","DOIUrl":"10.1016/j.urolonc.2024.11.013","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the diagnostic value of a comprehensive model based on unenhanced computed tomography (CT) images for distinguishing fat-poor angiomyolipoma (fp-AML) from homogeneous clear cell renal cell carcinoma (hm-ccRCC).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 27 patients with fp-AML and 63 with hm-ccRCC. Demographic data and conventional CT features of the lesions were recorded (including sex, age, symptoms, lesion location, shape, boundary, unenhanced CT attenuation and so on). Whole tumor regions of interest were drawn on all slices to obtain histogram parameters (including minimum, maximum, mean, percentile, standard deviation, variance, coefficient of variation, skewness, kurtosis, and entropy) by two radiologists. Chi-square test, Mann–Whitney <em>U</em> test, or independent samples t-test were used to compare demographic data, CT features, and histogram parameters. Multivariate logistic regression analyses were used to screen for independent predictors distinguishing fp-AML from hm-ccRCC. Receiver operating characteristic curves were constructed to evaluate the diagnostic performances of the models.</div></div><div><h3>Results</h3><div>Age, sex, tumor boundary, unenhanced CT attenuation, maximum tumor diameter, and tumor volume significantly differed between patients with fp-AML and those with hm-ccRCC (<em>P</em> &lt; 0.05). The minimum, mean, first percentile (Perc.01), Perc.05, Perc.10, Perc.25, Perc.50, Perc.75, Perc.90, Perc.95, and Perc.99 of the Fp-AML group were higher than those of the hm-ccRCC group (<em>P</em> &lt; 0.05). Coefficient of variance, skewness, and kurtosis were lower than those in the hm-ccRCC group (all <em>P</em> &lt; 0.05). Age, maximum tumor diameter, unenhanced CT attenuation, and Perc.25 were independent predictors for distinguishing fp-AML from hm-ccRCC (all <em>P</em> &lt; 0.05). The comprehensive model, incorporating age, maximum tumor diameter, unenhanced CT attenuation, and Perc.25, showed the best diagnostic performance (AUC = 0.979).</div></div><div><h3>Conclusion</h3><div>The comprehensive model based on unenhanced CT imaging can accurately distinguish fp-AML from hm-ccRCC and may assist clinicians in tailoring precise therapy, while also helping to improve the diagnosis and management of renal tumors, leading to the selection of effective treatment options.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 332.e1-332.e10"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142795233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative smoking exposure impacts oncologic outcomes of upper tract urothelial carcinoma","authors":"Raj Bhanvadia M.D. ,&nbsp;Emily Bochner M.D. ,&nbsp;Benjamin Popokh B.S. ,&nbsp;Jacob Taylor M.D. ,&nbsp;Antonio Franco M.D. ,&nbsp;Zhenjie Wu M.D., P.hD. ,&nbsp;Alessandro Antonelli M.D. ,&nbsp;Francesco Ditonno M.D. ,&nbsp;Firas Abdollah M.D. ,&nbsp;Giuseppe Simone M.D., P.hD. ,&nbsp;Gabriele Tuderti M.D., P.hD. ,&nbsp;Andreas Correa M.D. ,&nbsp;Matteo Ferro M.D. ,&nbsp;Marco Tozzi M.D. ,&nbsp;Francesco Porpiglia M.D. ,&nbsp;Antonio Tufano M.D. ,&nbsp;Sisto Perdonà M.D. ,&nbsp;Stephan Broenimann M.D. ,&nbsp;Nirmish Singla M.D. ,&nbsp;Ithaar H. Derweesh M.D. ,&nbsp;Vitaly Margulis M.D.","doi":"10.1016/j.urolonc.2025.01.018","DOIUrl":"10.1016/j.urolonc.2025.01.018","url":null,"abstract":"<div><h3>Background</h3><div>The impact of cumulative smoking exposure (CSE) on oncologic outcomes for upper tract urothelial carcinoma (UTUC) remains understudied. We examined the effect of this factor on oncologic outcomes in UTUC patients undergoing radical nephroureterectomy utilizing a large contemporary multicenter, multinational cohort.</div></div><div><h3>Methods</h3><div>Multicenter review of 1,730 patients across 17 institutions. A total of 1,041 patients met selection criteria: nephroureterectomy for urothelial carcinoma without variant histology and complete pathologic and smoking data. Smoking exposure was stratified as light, moderate, or heavy by cigarettes per day and years smoking based on prior studies. Cancer-specific (CSS) and overall survival (OS) were assessed using Kaplan–Meier and multivariable hazards models. A sub-analysis examined the effect of smoking cessation on survival stratified by CSE.</div></div><div><h3>Results</h3><div>Median follow-up (IQR) was 24 (10–48) months. Light CSE was equal to a median of 2.0 pack years smoked, moderate CSE was equivalent to 13.0 pack years, and heavy CSE was equivalent to 40 pack-years. Five-year CSS and OS were 97% and 91% in nonsmokers, 96% and 89% with light exposure, 85% and 66% with moderate exposure, and 75% and 60% with heavy exposure. On multivariable hazards models, both moderate and heavy smoking exposure were associated with worse CSS and OS compared to nonsmokers. Smoking cessation was not associated with improved survival outcomes among patients with moderate or heavy CSE.</div></div><div><h3>Conclusions</h3><div>Increasing CSE was associated with worse general health and oncologic outcomes in this UTUC cohort. Smoking cessation can modulate cancer outcomes up to certain thresholds of smoking exposure, emphasizing the need for both early smoking cessation and continued aggressive cancer treatment in patients with UTUC.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 330.e19-330.e29"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines versus real-world data in metastatic bladder cancer: A population-based study on first-line chemotherapy treatment patterns","authors":"Ellis Slotman M.Sc. ,&nbsp;Anke Richters Ph.D. ,&nbsp;Heidi P. Fransen Ph.D. ,&nbsp;Tineke J. Smilde Ph.D. ,&nbsp;Yvette M. van der Linden Ph.D. ,&nbsp;Sabine Siesling Ph.D. ,&nbsp;Katja K.H. Aben Ph.D. ,&nbsp;Natasja J.H. Raijmakers Ph.D. ,&nbsp;ProBCI study group","doi":"10.1016/j.urolonc.2024.10.026","DOIUrl":"10.1016/j.urolonc.2024.10.026","url":null,"abstract":"<div><h3>Background</h3><div>For patients with metastatic bladder cancer (mBC) palliative chemotherapy is one of the main treatment options. Real-world insights into outcomes are available, but a comprehensive overview of specific treatment details like number of chemotherapy cycles received and (reasons for) adjustments is lacking.</div></div><div><h3>Methods</h3><div>A population-based study was conducted, including all patients diagnosed with mBC in the Netherlands between 2016 and 2021 who started chemotherapy as initial treatment. Data on patient, tumor, and treatment characteristics, including number of cycles, adjustments and reasons for adjustments, and survival were collected from the Netherlands Cancer Registry. Treatment patterns and outcomes were analyzed descriptively. Logistic regression analysis was used to identify factors associated with receiving the full guideline-recommended treatment (4–6 cycles).</div></div><div><h3>Results</h3><div>A total of 684 patients started first-line chemotherapy, mostly carboplatin-based (54%). Of these patients, 35% did not receive the full course of treatment. Among these patients who received &lt;4 cycles, 24% died within one month of stopping treatment. Male sex and good performance status were independently associated with receiving the full course of treatment. Among patients who did receive a full course of treatment, half still had adjustments to their treatment schedule, which mainly included dose reductions due to side effects.</div></div><div><h3>Conclusions</h3><div>Among patients with mBC starting first-line chemotherapy, only a small majority received the recommended number of cycles, and treatment adjustments were common. This suggests that adhering to recommended treatment is challenging, emphasizing the importance of integrating insights on treatment discontinuation and modifications into the shared decision-making process and guideline development.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 328.e17-328.e24"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the effect of patient characteristics on the association between warm ischemia time and the risk of postoperative acute kidney injury after partial nephrectomy","authors":"Pietro Scilipoti M.D. ,&nbsp;Giuseppe Rosiello M.D. ,&nbsp;Federico Belladelli M.D. ,&nbsp;Francesco Pellegrino M.D. ,&nbsp;Francesco Trevisani Ph.D. ,&nbsp;Arianna Bettiga M.Sc ,&nbsp;Chiara Re M.D. ,&nbsp;Giacomo Musso M.D. ,&nbsp;Francesco Cei M.D. ,&nbsp;Lucia Salerno M.D. ,&nbsp;Zhe Tian M.Sc ,&nbsp;Pierre I. Karakiewicz M.D. ,&nbsp;Alexandre Mottrie Ph.D. ,&nbsp;Isaline Rowe Ph.D. ,&nbsp;Rayan Matloob M.D. ,&nbsp;Alberto Briganti Ph.D. ,&nbsp;Roberto Bertini M.D. ,&nbsp;Andrea Salonia Ph.D. ,&nbsp;Francesco Montorsi M.D. ,&nbsp;Alessandro Larcher M.D. ,&nbsp;Umberto Capitanio M.D.","doi":"10.1016/j.urolonc.2024.11.002","DOIUrl":"10.1016/j.urolonc.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>The impact of warm ischemia time (WIT) on renal function after partial nephrectomy (PN) remains debated. This study investigates the effect of WIT on the relationship between preoperative comorbidities and postoperative renal function impairment in renal cell carcinoma (RCC) patients.</div></div><div><h3>Methods</h3><div>Patients undergoing PN for T1 RCC at a European high-volume center (2000–2023) were analyzed. Logistic regressions assessed the association between patient comorbidities and acute kidney injury (AKI). Patients were stratified into low (LR), intermediate (IR), and high-risk (HR) groups based on a weighted comorbidity score derived from odds-ratio obtained from the logistic regression analysis. Interaction terms and a weighted local polynomial smoother function assessed the impact of WIT on AKI. Cox regressions and cumulative incidence were used to assess the chronic kidney disease (CKD) upstage ≥IIIB risk according to AKI and risk groups.</div></div><div><h3>Results</h3><div>Of 1,048 patients, 802 underwent PN with warm ischemia. Among these, 339(42%), 208(26%), 255(32%) were classified as LR, IR and HR. IR (OR:1.82, <em>P</em> = 0.018) and HR (OR:3.01, <em>P</em> &lt; 0.001) patients had a higher AKI risk compared to LR. The increase in WIT had little impact on the LR AKI probability compared to IR (OR:1.06, <em>P</em> = 0.001) and HR (OR:1.08, <em>P</em> &lt; 0.001). The 10-year risk of CKD-upstage ≥IIIB was higher (36% vs. 12%, HR:2.40, <em>P</em> = 0.004) after AKI, and in the HR group (HR:2.42, <em>P</em> = 0.008)</div></div><div><h3>Conclusions</h3><div>WIT predominantly affected the risk of AKI in HR patients for renal function impairment after surgery. Preoperative counseling is essential for comorbid patients, especially when planning complex surgeries with prolonged ischemia, to mitigate AKI and long-term renal impairment.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 333.e1-333.e8"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram for predicting survival in patients with primary testicular lymphoma: A population-based study","authors":"Hao Zhang M.D. ,&nbsp;Yuwei Yang Ph.D. ,&nbsp;Yan Cao Ph.D. ,&nbsp;Jingzhi Guan Ph.D.","doi":"10.1016/j.urolonc.2024.12.274","DOIUrl":"10.1016/j.urolonc.2024.12.274","url":null,"abstract":"<div><h3>Background</h3><div>Primary testicular lymphoma (PTL) is a rare malignancy whose epidemiology and prognosis have not been studied.</div></div><div><h3>Materials and methods</h3><div>PTL patient data were collected from the SEER online database, and the data were divided into a training cohort and a validation cohort according to random assignment. The training cohort was subjected to a one-way COX regression analysis, and statistically significant differences were included in the multi-factor COX regression analysis and constructed nomograms. Forest plots were constructed based on risk factors. The validity of the nomograms was verified by observing the C-index size of the nomograms, the percentage of area under the ROC curve, and the degree of fit of the prediction curve in the calibration plot. The validation cohort verified the accuracy and applicability of the nomograms.</div></div><div><h3>Result</h3><div>The patient's age, tumor histologic type, Ann Arbor stage, grade of differentiation, and whether or not they received radiation and chemotherapy were significantly associated with poor prognosis in PTL.</div></div><div><h3>Conclusion</h3><div>The nomogram constructed based on multivariate COX regression analysis can predict the prognosis of PTL patients. The online visualization nomogram can help clinicians calculate the survival rate of PTL tumor patients and conduct personalized prognostic assessments for PTL tumor patients.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 337.e9-337.e21"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter study of active surveillance for small renal masses: Real world practice pattern","authors":"Tarek Ajami ,&nbsp;Eric Villalba Lázaro ,&nbsp;Enrique Trilla Herrera ,&nbsp;Cristina Ferreiro Pareja ,&nbsp;Arnau Abella Serra ,&nbsp;Albert Francés Comalat ,&nbsp;Nicolas Valdes Figueroa ,&nbsp;Carlos Adrián Aguayo Eldredge ,&nbsp;Miguel Ángel Lopez-Costea ,&nbsp;José Ignacio Pérez Reggeti ,&nbsp;Carlos González Satué ,&nbsp;Sergio Bernal Salguero ,&nbsp;Gueisy Delgado Ortega ,&nbsp;Lluís Cecchini Rosell ,&nbsp;María José Ribal ,&nbsp;Mireia Musquera ,&nbsp;David Lorente García ,&nbsp;Section Of Uro-Oncology Of Catalan Urologic Society","doi":"10.1016/j.urolonc.2025.01.009","DOIUrl":"10.1016/j.urolonc.2025.01.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Active surveillance (AS) is a safe strategy for small renal masses (SRM) suspicious of renal cell carcinoma. In this study we analyze real world outcomes of active surveillance SRM from 5 tertiary Spanish centers, assessing clinical, radiological, and pathological characteristics, as well as therapeutic options.</div></div><div><h3>Methods</h3><div>A multicenter retrospective review was conducted including patients on AS from January 2012 to September 2024. We analyzed the indication for AS, initial lesion size, growth rate (GR), and progression on active surveillance. Cox regression analysis was performed to identify predictor of deferred intervention (DI).</div></div><div><h3>Results</h3><div>A total of 384 patients with renal tumors were included in AS, with an initial mean tumor size of 20.5mm. With a mean follow-up period of 43 months, the average GR across the cohort was 1.4 mm/y. About 15% of patients (<em>n</em> = 59) received active treatment (partial nephrectomy 56%, radical nephrectomy 16%, and radiofrequency 28%). Age, tumor size and tumor growth were factors correlated with delayed intervention, and only initial tumor size was correlated with GR. Pathological analysis after active treatment showed high grade clear cell carcinoma in 43.5% of cases with a GR of &gt; 5 mm/y, as compared to 19.4% of oncocytomas in slow growing lesions. No disease progression nor cancer-specific deaths were observed in our series.</div></div><div><h3>Conclusions</h3><div>In our multicenter cohort, AS is a valid option for SRMs without affecting oncological outcomes, with clinical factors such as age, tumor size, GR and initial biopsy influencing decisions on intervention.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 334.e1-334.e6"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}